Understanding Pain - Link Dump

If the world made perfect sense then pain and injury would be the same thing. As it turns out, tissue damage and pain are incredibly poorly correlated despite common sense telling us otherwise. Over a good while I've been doing my very best to understand pain and how it works and I've decided to dump some links that I've found particularly helpful in my learning process.

This is a really important issue to me because I have been a chronic pain sufferer in the past and my treatment was very poorly done on the whole. The bad news is that even most people in medicine and rehab roles have no clue about modern pain science despite a large amount of high quality research. The good news is that for those who suffer from pain, education alone can dramatically reduce that pain. The great news is that if this information is spread to both ends of the spectrum that the way pain is dealt with will improve by gigantic amounts very quickly.

This is not an easy subject and there are a lot of things to unlearn in understanding pain. Links are posted in order that I think they should be read/watched:

Pain education when combined with exercise (of any kind) is superior for the prevention of low back pain.

A few months ago I would have been staggered with the fact that "traditional" low back exercises outperformed "stability" exercise as the leaders in biomechanics seem to indicate the lumbar area's primary need for injury prevention is endurance stability. My new(ish) and improved understanding of pain allows everything here to make sense.

Hey thanks a lot for posting this stuff... there's some science in here that I hadn't come across yet, and as a sufferer of chronic lower back pain myself, I watch the internet like a hawk for new information constantly.

If (pretty stable long term) anectdotal evidence is fair game in here, I'll post what has helped me in case it can help anybody else.

First, the damage: About 8 years ago I had the disc at L4-L5 rupture. They did two surgeries, and during the 2nd they found a massive infection from the first surgery, so they removed as much of the disc as they could, did not fuse the vertebrae, and sewed me back up. I have large amounts of scar tissue around the sciatic nerve because of this (MRI has confirmed the nerve is still impinged), and chronic pain.

What has Helped:

(Physical): Anything which decompresses the spine will relieve the pressure on the impinged nerve, and cause relief. Swimming relieves the pain, as gravity is no longer compressing the nerve. Road biking helps, as the arched back posture spreads out the vertebrae and reduces pressure that way. Tai Chi wuji posture and doing the yang forms has helped because moving the workload for supporting the bulk of my mass moves from the lower back to the thighs, thus relieving the impingement. Relief is immediate. In all three cases, relief only lasts for as long as I'm doing the activity.

(Mental): Anything which focuses the brain on something else will dramatically reduce the pain. Video games which require intense concentration, meditation, and mentally calculating the results to difficult math problems has helped reduce the pain 2-3 points, although again, the effect only lasts as long as I'm continuing in that activity.

I'm doing my PhD on the subject of chronic pain. Basicaly the fact you can't see an injury to the tissue is because of a few possibilities.
A. It passed, healed but the changes to your nervous system persist.
B. There is some chronic inflamation still.
C. There is damage but it is unnoticeable.
An interesting article about the link between pain and inflammation. Look it up.
The main stream litrature thinks that changes to the CNS even the brain itself is to blame for chronic pain.
We noticed and published that there are long lasting changes to the PNS at the DRGs. And we shifted focus from the neurons to the satellite glial cells there.
Blocking augmented sgc coupling to other sgc reduced the pain.
The good news is doctors no longer dismiss it as psychosomatic.